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標題: GATS下之美印醫療服務貿易自由化協商
The U.S.-India Negotiation on Trade in Health Services under GATS.
作者: 王致祥
Wang, Chih-Hsiang
Contributors: 宋興洲;廖舜右
卓慧菀
中興大學
關鍵字: GATS;trade in health services;India;United States;neoliberal institutionalism
GATS;醫療服務貿易;印度;美國;新制度自由主義
日期: 2011
Issue Date: 2012-09-04 16:15:25 (UTC+8)
Publisher: 國際政治研究所
摘要: 近年來美印間醫療服務貿易快速發展,同時為兩國的醫療服務產業帶來機會及衝擊。而美印醫療貿易的快速發展也代表兩國醫療服務產業結構有些許互補之處,進行貿易將為兩國帶來不同形式之利益。根據新自由制度主義之看法,兩國將選擇在國際機制內就醫療服務貿易之不同模式進行合乎本身利益之自由化協商。在現行之國際貿易體系下,GATS應為協助WTO會員國進行服務貿易自由化協商之國際機制,然而,現階段GATS之運作及協商並不順利,各界對其功能也多有質疑。本論文旨在探究以下問題:第一,美印兩國在美印醫療服務貿易中之利益為何?第二,GATS協商機制是否有助於美印醫療服務貿易自由化之協商?
本研究發現三項結論:第一,美印兩國在美印醫療服務貿易中之利益以不同形式呈現,美國醫療體系可藉由貿易提高其可及性並降低成本與病人之經濟負擔;而印度醫療體系則可獲得大量資金及就業機會。第二,GATS對促進目前美印醫療服務貿易自由化程度並沒有顯著之貢獻,且其協商架構亦不利於後續之自由化協商。第三,本研究認為在協商結構設計不良的情形下,國際機制未必有助於國際合作。然而近期美印兩國選擇以建立雙邊國際機制之方式推動貿易自由化,並協助WTO及GATS多邊國際機制進行協商一事,顯示國家仍倚賴國際機制做為進行國際合作之平台,美印兩國亦仍將協商重點置於GATS及WTO之上。
Trade in health services between United States and India has grown rapidly in recent years, which brought health industries in these two countries both business opportunities and impacts. This phenomenon also shows health industries in these two countries are potentially complementary, which means trade with each other would bring both countries benefits in different ways. According to neo-liberal institutionalism, U.S. and India would negotiate on liberalization of trade in health service through international regimes in order to maximize their benefits. The international regime which is responsible for promoting liberalization of trade in services is GATS. However, GATS has long been questioned for its ill function. This research tries to answer the following questions: First, what are the benefits for U.S. and India from their bilateral trade in health services? Second, Is GATS capable of promoting negotiation on liberalization of U.S.-India trade in health services?
This research finds: First, the U.S.-India trade in health services creates different benefits for U.S. and India. Through trade, U.S enjoys higher healthcare accessibility and lower cost while India enjoys economic gains, FDI inflows and better employment situation. Second, GATS has not facilitated substantial liberalization of U.S.-India trade in health services. Furthermore, GATS'' method of negotiation is detrimental to the ongoing negotiations. Third, this study finds when the negotiation method of the international regime isn''t properly designed, the international regime may fail to perform its function in promoting international cooperation. However, the fact that U.S. and India are continuing their efforts in establishing bilateral regime to liberalize trade and to assist WTO Doha round negotiation reveals that most countries still heavily rely on international regimes when conducting international cooperation. This serves as an evidence that India and U.S. still take GATS and WTO as the primary negotiating platform for trade liberalization.
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